Liraglutide Versus Insulin Glargine In Patients With Type2Diabetes Mellitus Inadequately Controlled On Metformin

Objective：To evaluate the effect and safety of the human glucagon-like peptide-1(GLP-1)analogue liraglutide versus insulin glargine in patients with type2diabetesMellitus(T2DM) inadequately controlled on metformin alone, and provide theladder therapeutical basis for type2diabetes mellitus who did not achieveadequate glycaemic on metformin.Methods：90T2DM patients who hadinadequate glycaemic control on metformin wereallocated for the research witha randomized，open，parallel controlled clinicalresearch method.90case of T2DM patients keeped the original dose of metformin unchangedwere randomly assigned to the liraglutide (LIRA) group or the insulin glargin(IGla) group according to a proportion of1:1.The treatmentperiod was26weeks. At the baseline,4weeks after treatment,12weeks after treatment,20weeksafter treatment and26weeks after treatment, the baseline index, glucose metabolismindex, lipid metabolism index,3h C peptiderelease test,blood routine,urine routine,liver and kidney function, blood amylase, electrocardiogram, heartcolor ultrasonic andthyroid color ultrasonic were arranged to measured.Results：1、86case of T2DM patients completed the study, of which LIRA group completed44cases, IGla group completed42cases. The baseline characteristics of patientswere comparable in the two groups. 2、In glucose metabolism, after26weeks of treatment, FPG、2hPG and HbA1calldecreased in the two groups (P<0.05or P<0.01). Comparison between groups, FPGdeseased greater in IGla group,2hPG deseased greater in LIRA group(P<0.05orP<0.01).Mean HbA1cand the success rate of HbA1c<7%were simlar between LIRAgroup and IGla group(P>0.05), while the percentage of subjects reaching thecomposite endpoint of HbA1c<7%with no hypoglycemia and no weight gain wassignificantly higher in LIRA group than insulin group (P<0.05).3、In weight control, after26weeks of treatment, compared with the baseline,liraglutide significantly reduced mean body weight (3.21±1.18kg),waist circumference(3.82±1.21cm)and body mass index (BMI)(1.95±0.61kg/m2)(P<0.01or P<0.05).4、In control of blood pressure and pulse, after26weeks of treatment, the systolicblood pressure decreased in LIRA group(P<0.01), no obvious difference wasobserved in IGla group (P>0.05)；No obvious difference was observed in diastolicblood pressure of the both two groups compared with baseline(P>0.05).5、In safety and tolerance, there was no serious adverse occured in the two groups, theincidence of adverse reactions was frequent in LIRA group, mainly for thegastrointestinal adverse reaction.There was no severe hypoglycemia event occured inthe two group. The incidence of mild hypoglycemia was significantly less in LIRAgroup and has a statistically significant difference (4.35%vs20.45%，P<0.05).Conclusions：1、It was found that it had a similar reduction on HbA1cin the patients with type2diabetes mellitus inadequately controlled on metformin, combined with liraglutide orinsulin glargine. Liraglutide had a superior effect on the percentage of subjectsreaching the composite end point(HbA1cless than7%with no hypoglycemia and noweight gain) and had good safety and tolerability.2、It was found that liraglutide showed a good effect on reducing weight and systolicblood pressure(SDB), restoring the C peptide release curve, and improving blood lipid,in addition to reduce blood glucose compared with the insulin glargine.